Volume 8 no 2

ADVICE: The sweet space of executive coaching: when leadership gets messy

Debrah Wirtzfeld, MD, CEC

 

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ADVICE: The sweet space of executive coaching: when leadership gets messy

Debrah Wirtzfeld, MD, CEC

 

The basis of successful leadership rests in leading and developing your people, not in maintaining the status quo. In transition to a new leadership role, medical leaders will often try to mend historical conflicts and build new and trusting relationships. However, about six months in, old patterns begin to surface and the messiness of leadership rears its ugly head. Leaders must recognize that this is where their leadership begins — with growing their people and leading their teams through the inevitable messiness of leadership. To meet this challenge, leaders must understand the reason they have come to leadership. To enhance team function, they must work to develop their internal self-awareness, an understanding of their own beliefs, values, and emotions, and external self-awareness, an appreciation of the impact of their words and actions on others. This can be amplified by understanding the value of “thinking slow” or looking at problems intentionally, without an automatic or intuitive response. The key is developing a deeper understanding of yourself and what you bring to leadership to support sustainable change in the health care system, and this is where executive coaching can assist medical leaders — to limit the messiness and create a supportive environment for self-reflection and personal development.

 

Keywords: executive coaching, leadership development, leading self

 

Wirtzfeld D. The sweet space of executive coaching: when leadership gets messy. Can J Physician Leadersh 2022;8(2):72-7.

https://doi.org/10.37964/cr24752

 

 

As an executive leadership coach, I never cease to be impressed by the dedication and regard medical leaders have for the people on their teams. The vulnerability a leader shares when confronted with the realization that they can make or break their team, regardless of external factors, is very powerful. However, one of the most difficult concepts that a new leader, or even a seasoned leader in a new role, must grasp is that managers manage things and leaders lead people. This is often misinterpreted because people are messy.

 

During the early days in your new role, you are busy meeting people, forming strategic alliances, and assessing the match between people and priorities. People are watching as you set goals and define your vision for the position. Your team is excited by the idea of what is possible, and they should be as this is the time when it seems as if the world is your oyster. However, about six months in, give or take, you are hit with a cold dose of reality. No matter who you are, what you are trying to accomplish, or where you are positioned in an organization, the same old problems start to raise their ugly heads. Although, at first, it may have seemed as if the road was smooth and you were on your way to making a long-lasting and defining change, it now seems like your efforts were all for naught. What you might fail to recognize is that you have entered the space where true leadership lives and where you can actually make the most significant change — where the bright and shiny is wearing off and the messiness returns! This is when you go from a manager of things to a leader of people, and your people need you! Top

 

This view of leadership is elegantly summarized in a 2016 interview with Ed Catmull, co-founder of Pixar and former president of Walt Disney Animation Studios.1 In his reflections on leadership during times of transformation, he states:

 

The fundamental tension is that people want clear leadership, but what we’re doing is inherently messy. We know, intellectually, that if we want to do something new, there will be some unpredictable problems. But if it gets too messy, it actually does fall apart. And adhering to the pure, original plan falls apart, too, because it doesn’t represent reality. So you are always in this balance between clear leadership and chaos; in fact that’s where you’re supposed to be. Rather than thinking, “OK, my job is to prevent or avoid all the messes,” I just try to say, “well, let’s make sure it doesn’t get too messy.” Top

 

Both leaders and their people want leadership to be clear and decisive. Leaders are expected to know the policies, procedures, and rules. Historically, they have been expected to be able to apply them in an effective and efficient manner that will lead to peaceful restoration of the status quo. However, what we now recognize is that leaders have failed to take into consideration that their own biases and prejudices can often result in a failure to provide the psychological safety necessary for resolution. This adds to the mess and is often a blind spot for many leaders.

 

As a leader, what are some of the important issues you must consider to ensure that things don’t get too messy? What skills will you require to lead your team through these times of uncertainty? Top

 

Your first inclination might be to dive right in and try to fix things. If your team is going to survive, you must address issues as quickly as possible and set things right. However, leadership is not often quick, and it involves not only the content of the issues you are facing, it demands that you think about the relationships you are building and how these will be navigated and strengthened during your term. It requires that you get clear about what you bring to leadership and why you have chosen to lead.

 

Your why of leadership

 

Most of the time, leaders are caught in an endless cycle of what they need to do and how they need to do it, leaving little time to ponder the why of your leadership. The “Golden Circle,” as espoused by Simon Sinek,2 puts the why at the centre of the circle, with the what and the how encircling it and dependent on its definition. If you are not aware of why you are in leadership, the difficult times when things get messy will force you to question your role and even your ability as a leader. Top

 

About a year into a senior leadership position, “Dr. Smith” approached me about executive coaching. The issue their team was facing was around equity in the call schedule, which was causing tension among team members. Dr. Smith was concerned as this was the first major issue they had been forced to address during their tenure, and historical lines of allegiance were once again beginning to emerge. Dr. Smith felt that they would have been able to prevent the discontent among team members, if only they had been a better leader. What they failed to realize was that conflict prevention is not the work of a leader, but rather managing relationships during times of tension. We began the coaching relationship by exploring their why of leadership.

 

As might have been expected, this was not as easy as it seemed. Dr. Smith wanted to focus on the what and the how of the call schedule. However, by considering what they wanted to accomplish for their team members, the organization, and themselves, they were able to identify that their why of leadership was to develop team members, be seen as a transparent and authentic leader, and provide a safe place for open dialogue. Each time conflict arose, they were able to remind themselves and others of their why of leadership. This allowed the members to regroup and focus their activities on the task at hand. Top

 

Look internally to lead your team

 

Knowing your why of leadership is an important first step; however, effectively leading a team will require you to reflect more deeply. Self-awareness is an essential component of leading self. It is often one of the most difficult elements for leaders to tackle, as it demands an objective assessment of what you are contributing to a dysfunctional situation. You must turn the focus on yourself instead of looking for the answer in the “problems others are creating for you” or “the dysfunctions inherent in your team.”

 

Self-awareness has two crucial elements: internal and external.3 Internal self-awareness is an extension of knowing your why; it is awareness of your values, beliefs, and emotions, and how these relate to team function.3 As a leader, it is important that you understand that these elements of your internal awareness represent who you are and what you have experienced, rather than the indisputable truth. Failure to understand yourself in relation to others can lead to attributing the behaviours of team members to negative intent or faulty character, while thinking that your contribution is a product of your circumstances or a fault of the environment. Internal self-awareness can deepen appreciation of the possible motives of others beyond negative attributions that can disrupt the functions of the team.  Top

 

Internal self-awareness is found in the ability to reflect on what an appropriate response might look like and in an understanding of how your own values, beliefs, and especially emotions are contributing to the situation.3 As a leader, it rests in your ability to separate the facts from the story you are telling yourself and negative assumptions you are making about the other person(s).4 It helps to remember that, in any situation, there are generally few facts and most of what you are basing your response on is your interpretation, an assessment that is biased by past experience and an impression of how things should be.

 

External self-awareness refers to an understanding of how your words and actions affect others on the team.3 Without this knowledge and a curiosity around how you are perceived by others and the impact you have on them as a leader, it will not be possible to provide the psychological safety your team needs to function effectively.4 External self-awareness comes with an acceptance that your intentions might not always align with your impact and that a significant contribution to the dysfunction of your team might lie in your inability to decipher how you are being perceived as a leader. It also requires self-compassion and a strong desire to improve, as this is where most of the hard work around self-awareness happens. Top

 

It is not uncommon for leaders to ponder how they can assess the impact that their words and actions have on others. Short of providing a psychologically safe environment where feedback is encouraged, leaders want to know if there are any other clues about how their message is landing. The art of communication is found in leaders who pay attention, not only to what is being said, but also what is not being said.3,4 As a leader, you can build on your external self-awareness by paying attention to how your message is received. A change in body language, demeanor, or a pause in the conversation by the recipient could signal that your message has not landed in the way you intended. You might ignore these important signals as you do not want to wander in the direction of a difficult conversation. However, it is precisely in these moments that you will come to understand your people, the strengths they bring to the team, and what they need to be successful. Top

 

Over the last several years, the ability to assess how your message is being received has been seriously impacted by COVID-19 and a shift to a virtual meeting environment. Access to nonverbal cues has become limited. We see most people from the chest or neck up, and some may even have their cameras off. However, there is a science to reading people, and, if you remain focused on identifying what is behind the words, you can still have an impact.

 

Look for signs of agreement and understanding, specifically participants nodding or maintaining eye contact with you when you speak.5 Frustration can be seen in someone raising their shoulders or eyebrows. Disagreement can be revealed by a look of concern, someone wrinkling their forehead, crossing their arms, or diverting their eyes away from the camera. Obviously, you cannot be looking for these somewhat subtle cues in all participants at the same time. As with an in-person meeting, you will need to be selective about whom you are paying attention to during any discussion given your previous understanding of where people tend to sit on various issues. You will need to be more astute in your attempts to be inclusive, perhaps even letting people you wish to speak to about a subject know beforehand that you will be calling on them during the meeting. Be transparent by acknowledging that recognizing cues in a virtual world is difficult and that you want to be inclusive of all voices. Invite people to raise their hands and to enter comments in the chat box. Your focus must be on recognizing what cues you have available to you, being open to the possibility that there may be misinterpretation, and ensuring that all voices are heard.  Top

 

There are also nonverbal cues that are not visual.6 Before the onset of COVID-19, the practice of coaching often involved telephone-based interactions. This might seem counterintuitive as one of the tenets of coaching is being able to assess nonverbal signals and how these relate to what might not be said or what a client is truly passionate about. There is a lot to be found in the tone, pitch, and cadence of speech.6 The same is true for virtual meetings. If someone increases the cadence of their speech, it could signal excitement or passion. A change to a more silent tone might signal a lack of confidence in what is being said. It is not important that you be able to recognize exactly what the other person is thinking or feeling; rather, it is important that you notice the change. Based on the situation, you might choose to bring attention to it during the meeting or you might make a mental note that you need to speak with someone later. As with visual cues, these cues have always been there. It is up to you to sharpen your focus and be courageous in speaking with them. Top

 

The value of slow thinking in leadership

 

Understanding your why and working on yourself first are important in all aspects of leadership, but they are of particular significance in situations where you will benefit from thinking slow.7 As defined by Kahneman in Thinking, Fast and Slow,7 slow thinking refers to a more deliberate type of thinking, often surrounding complex systems. Involved in problem-solving and requiring you to monitor and control your emotions and behaviour, slow thinking can lead to strengthened relationships and sustainable outcomes. This is not, however, the type of thinking that most physicians, especially seasoned practitioners, engage in daily during clinical interactions with patients. You are more likely to engage in fast thinking, which is automatic, intuitive, and seeks to assimilate what you see with previously held beliefs.7 This type of thinking leads you to confirm what you already know rather than considering novel information or ideas, especially when faced with difficult leadership issues. Top

 

In the fast-paced world of medical leadership where there seems to be a constant need to answer urgent concerns in rapid sequence or fast thinking, leaders must be deliberate about finding the space for slow thinking. First, leaders must acknowledge that fast thinking is emotional and prone to confirmation bias.8 It does not consider diverse opinions and may negate important information. Understanding that this can lead to uninformed decisions should alert leaders to the value of finding the time for reflection.9 It can even make you more productive.10 The way to approach this in a fast-paced world is to recognize when you do your best work and set aside 20–30 minutes several times a week to dedicate to slowing down the speed of your thoughts and becoming more intentional. Knowing the space that works best for you, whether while sitting or walking, and what the background is like will also be important. Finally, know what you want to think about. Many great questions will streamline your workflow and define your accountabilities to long-term outcomes.10 Coaching is a valuable space to consider some of these questions in more depth with a reflective partner.11

 

As an executive coach, when I suggest to medical leaders that “solving” leadership problems might require them to engage in thinking slow and that not all leadership problems are urgent, this often gives them the mental space they need to think about building for sustainable success with their teams. That inequity in the call schedule has existed for a decade or longer and does not need to get solved by the end of next week using an automatic or intuitive approach. In fact, that type of thinking can lead to a failure to consider all options and all voices — it misses valuable information. The problem can be addressed over a period of, say, six months or a year, in a logical and deliberate way that seeks input from all, identifies and minimizes risk, and celebrates successes. This type of thinking is necessary to support your teams in sustainable transformation of our complex health care system. Top

 

The value of executive coaching in messy leadership

 

Executive coaching has been defined by the International Coaching Federation as “partnering with clients in a thought provoking and creative process that inspires them to maximize their personal and professional potential. The process of coaching often unlocks previously untapped sources of imagination, productivity, and leadership.”11 As such, it is well positioned to assist in the messiness that is medical leadership. Understanding your why of leadership, building your self-awareness, and thinking slowly are not solo activities, and they are difficult to achieve during the routine hustle and bustle of the packed daily agenda that most medical leaders face. Coaching accepts that you hold the answers to your leadership challenges and that these can be discovered through a relationship with your coach that is centred on self-discovery and growth.

 

The Canadian Society of Physician Leaders supports coaching as a valuable asset in the development of medical leaders.12 It is aligned with the LEADS framework, most significantly Leading self, and can assist with mitigating the messiness of human relationships that are at the centre of all successful leadership initiatives. Top

 

References

1.Rao H, Sutton R, Webb A. Staying one step ahead at Pixar: an interview with Ed Catmull. McKinsey Q 2016;29 Mar. Available: https://tinyurl.com/5n6uvv9k

2.Sinek S. Start with why: how great leaders inspire everyone to take action. New York: The Penguin Group; 2009.

3.Porter J. To improve your team, first work on yourself. Harv Bus Rev 2019;29 Jan. Available: https://tinyurl.com/yvrsjju4

4.Patterson K, Grenny J, McMillan R, Switzler A. Crucial conversations tools for talking when stakes are high (2nd ed.). New York: McGraw-Hill; 2011.

5.RingCentral Team. 5 nonverbal cues to look for when you’re on a video call. RingCentral blog 2021:18 Nov. Available: https://tinyurl.com/tmzyjp6x

6.Higton B. Types of non-verbal communication and its impacts on public speaking. Media Writing blog 2016;20 Apr. Available: https://tinyurl.com/2hh76fzs

7.Kahneman D. Thinking, fast and slow. Toronto: Anchor Canada; 2011.

8.Carlson B. Lessons from thinking fast and slow. A Wealth of Common Sense blog 2013;21 May. Available: https://tinyurl.com/2z9639d9

9.Thomas A. 4 reasons why slowing down will actually make you more successful. Inc. blog 2019;29 Jan. Available: https://tinyurl.com/mr4964c4

10.Bonnevalle N. A room of one’s own: how leaders can create time and space to think. Amersterdam: Thnk; 2020. Available: https://tinyurl.com/2p992nme

11.What is coaching? Lexington, Ky.: International Coaching Federation; n.d. Available: https://coachingfederation.org/about

12.Physician leadership coaching. Ottawa: Canadian Society of Physician Leaders; 2020. Available: https://physicianleaders.ca/coaching.html

 

Author

Debrah Wirtzfeld, MD, CEC, CCPE, MBA, is the founder and CEO of MD Confidence Consulting. As an executive leadership coach, she has a passion for taking senior and executive medical leaders from good to great and great to excellent. She focuses on career transitions, including the podcast She Knows ShiFt. As a team development consultant, she works with leaders and their teams to optimize performance by adopting effective communication strategies and engaging in transparent and open discussion.

 

Correspondence to:

debrah@sheknowsshiFt.com

 

This article has been peer reviewed.

 

Top

As an executive leadership coach, I never cease to be impressed by the dedication and regard medical leaders have for the people on their teams. The vulnerability a leader shares when confronted with the realization that they can make or break their team, regardless of external factors, is very powerful. However, one of the most difficult concepts that a new leader, or even a seasoned leader in a new role, must grasp is that managers manage things and leaders lead people. This is often misinterpreted because people are messy.

Knowing your why of leadership is an important first step; however, effectively leading a team will require you to reflect more deeply. Self-awareness is an essential component of leading self. It is often one of the most difficult elements for leaders to tackle, as it demands an objective assessment of what you are contributing to a dysfunctional situation. You must turn the focus on yourself instead of looking for the answer in the “problems others are creating for you” or “the dysfunctions inherent in your team.”

In the fast-paced world of medical leadership where there seems to be a constant need to answer urgent concerns in rapid sequence or fast thinking, leaders must be deliberate about finding the space for slow thinking. First, leaders must acknowledge that fast thinking is emotional and prone to confirmation bias.8 It does not consider diverse opinions and may negate important information. Understanding that this can lead to uninformed decisions should alert leaders to the value of finding the time for reflection.9 It can even make you more productive.10 The way to approach this in a fast-paced world is to recognize when you do your best work and set aside 20–30 minutes several times a week to dedicate to slowing down the speed of your thoughts and becoming more intentional. Knowing the space that works best for you, whether while sitting or walking, and what the background is like will also be important. Finally, know what you want to think about. Many great questions will streamline your workflow and define your accountabilities to long-term outcomes.10 Coaching is a valuable space to consider some of these questions in more depth with a reflective partner.11